Haematopoietic Stem Cell Transplant for Norovirus-Induced Intestinal Failure in X-linked Agammaglobulinemia

J Clin Immunol. 2021 Oct;41(7):1574-1581. doi: 10.1007/s10875-021-01088-2. Epub 2021 Jun 23.

Abstract

Since the first clinical description in 1952, immunoglobulin replacement therapy remains the mainstay of treatment of patients with X-linked agammaglobulinemia (XLA). However, this therapy only replaces IgG isotype and does not compensate for the loss of Bruton tyrosine kinase in non-B-lymphocytes. Patients may still therefore develop complications despite current standard of care. Here, we describe an XLA patient with persistent chronic norovirus infection, refractory to treatment and causing intestinal failure. The patient underwent haematopoietic stem cell transplantation, curing XLA and allowed clearance of norovirus prior to humoral immunoreconstitution, suggesting non-humoral immunodeficiency in these patients.

Keywords: X-linked agammaglobulinemia; haematopoietic stem cell transplantation; inflammatory bowel disease; norovirus.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agammaglobulinemia / therapy*
  • Caliciviridae Infections / therapy*
  • Child
  • Genetic Diseases, X-Linked / therapy*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Intestinal Failure / therapy*
  • Male
  • Norovirus*

Supplementary concepts

  • Bruton type agammaglobulinemia